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General NPI Number Information
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NPI Number | 1649276676
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Entity Type | Individual
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Provider Name | DR. JOHN JURIK
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 07/21/2016
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Provider Practice Location Address
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Address Line | 1500 PORTLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14621-3065
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Country | US
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Telephone | 585-697-6000
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Fax | 585-342-9166
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Provider Business Mailing Address
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Address Line | 1500 PORTLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14621-3065
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Country | US
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Telephone | 585-697-6400
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Fax | 585-342-9166
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 146563
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License Number State | NY
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